Individual provider Active NPI

Alexa-Rae Pesce, MD

  • Surgery Physician
  • Greenport, NY
National Provider Identifier
1609336221
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
331899 Issued in NY
Practice address
201 Manor PL
Greenport, NY 11944-1222
Phone
(631) 477-1000
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 331899 NY Primary

Addresses

Primary practice location

201 Manor PL
Greenport, NY 11944-1222

Mailing address

139 Park LN
Massapequa, NY 11758-4308
Phone (516) 641-8889

Other practice location 1

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1791

Other practice location 2

240 Meeting House Ln
Southampton, NY 11968-5009
Phone (631) 726-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904003514 NY Practitioner - General Surgery 6406182120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Drexel University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stony Brook Surgical Associates University Faculty Practice CorporatiGroup PAC ID 0345143749, 103 clinicians

Practice addresses (Care Compare)

255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
89.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)14
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Stony Brook Surgical Associates, University Faculty Practice Corporati Surgery CurrentSince Aug 1, 2024 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

201 Manor Pl
Greenport, NY 11944
Phone (631) 477-1000

10095 Main Rd
Mattituck, NY 11952
Phone (631) 213-4499

37 Research Way
Setauket, NY 11733
Phone (631) 444-4121

676 County Road 39A
#240
Southampton, NY 11968

240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409

100 Nicolls Rd
Rm 20
Stony Brook, NY 11794
Phone (631) 444-7646

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

100 Nicolls Rd
#T19
Stony Brook, NY 11794

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1609336221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 PARK LN",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584308",
            "telephone_number": "516-641-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MANOR PL",
            "city": "GREENPORT",
            "state": "NY",
            "postal_code": "119441222",
            "telephone_number": "631-477-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Nicolls Rd",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-444-1791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 Meeting House Ln",
            "address_purpose": "LOCATION",
            "city": "Southampton",
            "state": "NY",
            "postal_code": "119685009",
            "country_code": "US",
            "telephone_number": "631-726-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESCE",
        "first_name": "ALEXA-RAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "331899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenport, NY

Sources for this page

Verify at the official NPI Registry.